[Bacteriologic aspects of Haemophilus influenzae meningitis in children at the Central University Hospital of Treichville]. / Aspects bactériologiques des méningites dues à Haemophilus influenzae chez l'enfant au CHU de Treichville.

The object of our study was to contribute to the knowledge of the epidemiology and bacteriology of Haemophilus influenzae so as to ensure better treatment of patients consulting the Treichville Teaching Hospital. In the bacteriology laboratory of that hospital, between January 1996 and December 1999, we diagnosed by culture and/or soluble antigen, 203 cases of Haemophilus influenzae in children. We observed that biovar IV was dominant (49.7) amongst the 163 (80.3%) positive cultures. Serovar b was the most frequent capsular type found 189/203 (93%). Of the 203 specimens, the frequency of other capsular forms was e 9/203 (4.5%), f 3/203 (1.5%), c 2/203 (1%). Resistance to ampicillin is currently estimated at 39.9%, whereas resistance to chloramphenicol is estimated at 5.5%.

[Pygomelus. An African surgical case report]. / La pygomélie. A propos d'un cas african opéré.

Pygomelus is a malformation characterized by the presence of one or more extra-extremities in the pelvic region. This article describes a case of pygomelus involving a child in Cote d'Ivoire. It is the tenth operated case to be reported in the literature. The malformation consisted of a well developed third lower extremity attached to the right iliac crest, without a rudimentary pelvis, and of a poorly developed upper extremity attached to the subpubic region. The two extra-extremities were removed surgically without complications. Pygomelus is an uncommon malformation whose nosologic limits are unclear since it is comparable to lower extremity duplication and dipygus. According to the authors pygomelus is a more appropriate term than caudal duplication which is widely used in English-speaking physicians.

[Extravasation injuries in newborns: our experience about 15 cases]. / Les accidents d'extravasation perfusionnelle chez le nouveau-né : une expérience de 15 cas.

Extravasation injuries are common complications that occur during infusion for diagnostic or therapeutic purposes by the peripheral or central venous catheters. In pediatric settings, iatrogenic extravasations are serious. When they are viewed late, they are sources of functional sequelae. The purpose of this study was to report our experience with the management of iatrogenic extravasations for therapeutic purposes. Between January 2010 and December 2012, fifteen newborns were supported for accidents of infusion of the upper and the lower limbs. The male was mostly affected. The mean age was 3.6days, with extremes of one and nine days. The average birth weight was 2900g. The range was 1200g and 3550g. Serum 10 % glucose and calcium chloride were implicated in all cases. The lesions were seen in the late stages III in six cases and IV in nine cases. The upper limbs were frequently affected. Nine lesions were in the upper limbs and six in the lower limbs. The dorsal surfaces, feet and hands were frequently affected in six and five cases, respectively. Two lesions were in the anterior aspect of the forearm and elbow. Elbows lesions were circular and realized a tourniquet effect. Treatment was conservative in eleven cases: five pro-inflammatory fatty dressings and six alcoholic dressings. The surgery was delayed in four cases. It combined excision-full thickness skin graft, excision-dressing-thin skin grafting, debridement and two-full thickness skin graft for retractable wrist scars. Two deaths were related to associate pathologies. One patient was lost for follow-up. Our results were satisfactory in functional, aesthetic and psychological aspects. Extravasation injuries are serious iatrogenic lesions. If the lesions are seen at an early stage in usual circumstances, in extreme exercise, they are seen late, sometimes at the stage of functional, psychological and cosmetic sequelae. The difficulty of the therapeutic management of these lesions requires prevention through the development of protocols and the permanent training of nursing staff for an efficient practice of infusion.

Childhood cancer in Côte d'Ivoire, 1995 - 2004: challenges and hopes.

BACKGROUND: There is insufficient research into the state of paediatric oncology in African countries. OBJECTIVES: The purpose of this study was to analyse the state of paediatric oncology between 1995 and 2004 in Côte d'Ivoire. METHODS: This retrospective descriptive study analysed all patients under the age of 18 who were diagnosed with cancer in Côte d'Ivoire over a period of 10 years (January 1995 - December 2004) with regard to demographics, types of pathology, delay in diagnosis and treatment, treatment modalities, abandonment of treatment and survival rate. RESULTS: Of 405 patients diagnosed with cancer, 331 were included in the study. Burkitt's lymphoma was the most common malignancy (73.6%), followed by nephroblastoma (14.5%) and acute leukaemia (4%). Delay in diagnosis occurred in 38.7% of cases and ranged from 1 to 3 months; the average delay from diagnosis to starting treatment was 18 days. An abdominal mass and swelling of the jaw were the most common clinical presentations. Almost half of the patients (48.6%) were lost to follow-up and over a third (39.3%) died shortly after admission owing to advanced disease. The overall survival rate was 9.4%. CONCLUSIONS: Cancer in children in Côte d'Ivoire was dominated by Burkitt's lymphoma. The rate of loss to follow-up of almost 50% is grounds for concern. The overall survival rate of 9.4% is very low, but such figures are not uncommon for African countries. Collaboration within the Franco-African Group of Paediatric Oncology has contributed to improving the management of children with cancer.